00001, respectively). The site of tenderness was not indicative of the fractured spinal segment in 57% of all acute fractures (7 cervical, 15 thoracic, and 16 lumbar). No fracture was detected on WSCT in 10 subjects with an unspecified pain location. Multilevel distant fractures were detected in two patients with a specified pain location to only one of the fractures. CONCLUSION WSCT in DISH subjects after low-impact trauma is mandatory due to the high prevalence of acute fractures and the low specificity for fracture detection on radiographs. A targeted CT approach to the tender spinal segment proved to be inadequate and would have missed 57% of the acute single fractures with incompatible spinal tenderness location. These results support the significant role of WSCT in the ER setting for detecting and pinpointing the spinal fracture site of DISH subjects who present with low-impact trauma. LEVEL OF EVIDENCE 3.STUDY DESIGN A retrospective review of prospectively collected data. OBJECTIVE To compare quality of life (QOL) outcomes of posterior lumbar interbody fusion (PLIF) with lateral lumbar interbody fusion (LLIF) using reports from patients obtained at the 2-year postoperative follow-up. SUMMARY OF BACKGROUND DATA Indirect decompression with LLIF is used to treat degenerative lumbar diseases that require neural decompression. However, the difference in improvement in QOL following indirect decompression compared with direct neural decompression using PLIF is unclear. METHODS We enrolled 284 consecutive patients with degenerative lumbar spondylolisthesis in the present study, 203 who underwent PLIF and 81 who underwent LLIF. All patients completed a minimum of 2 years of follow-up. We evaluated the effectiveness of surgery in each category of the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). RESULTS The results of preoperative JOABPEQ and the severity of thecal sac stenosis were not significantly different between PLIF and LLIF, neither was the rate of perioperative complications (14.8% and 15.4% for the PLIF and LLIF groups, respectively; p?=?0.91). The effectiveness at 2 years postoperatively was almost the same for all five domains of the JOABPEQ 62.6% and 68.9% for pain-related disorders (p?=?0.34), 38.3% and 42.7% for lumbar spine dysfunction (p?=?0.51), 65.8% and 67.5% for gait disturbance (p?=?0.79), 53.5% and 48.8% for social life dysfunction (p?=?0.47), and 29.1% and 33.3% for psychological disorders (p?=?0.48) following PLIF and LLIF, respectively. Visual analogue scale results for back and lower-limb pain and numbness of the lower limbs were almost the same for both groups. No significant differences were observed in terms of perioperative complications and radiographical outcomes. CONCLUSIONS Indirect decompression using LLIF improves QOL and radiographical outcomes to a comparable degree as direct decompression via PLIF. LEVEL OF EVIDENCE 4.STUDY DESIGN Four-year, longitudinal cohort study. OBJECTIVE To investigate the effect of original spinal shape on incidental vertebral fractures and to identify the influence of changes in pre- and post-fracture geometrical spinal shape. SUMMARY OF BACKGROUND DATA Clinical evidence demonstrates that vertebral fractures cause spinal kyphosis, morbidities, and deteriorating quality of life in elderly people. However, knowledge of geometrical spinal shapes that affect incidental vertebral fractures is limited. METHODS Three hundred and seventeen volunteers underwent whole spine radiography as part of a health screening in both 2012 and 2016. We extracted volunteers with incidental vertebral fracture in 2016. Sex- and age-matched volunteers without vertebral fracture were enrolled as controls. Baseline demographic variables, geometrical spinal shape, and spinopelvic parameters were compared between the two groups. In volunteers with incidental vertebral fracture, we investigated the association between baseline ebra and fractured vertebra. Our study helps to understand the influence of geometrical spinal shape on the risks of vertebral fracture. LEVEL OF EVIDENCE 3.STUDY DESIGN Numerical planning and simulation of immediate and after 2 years growth modulation effects of anterior vertebral body growth modulation (AVBGM). OBJECTIVE The objective was to evaluate the planning tool predictive capability for immediate, 1-year, and 2-year postoperative correction and biomechanical effect on growth modulation over time. SUMMARY OF BACKGROUND DATA AVBGM is used to treat pediatric scoliotic patients with remaining growth potential. https://www.selleckchem.com/products/CP-673451.html A planning tool based on a finite element model (FEM) of pediatric scoliosis integrating growth was previously developed to simulate AVBGM installation and growth modulation effect. METHODS Forty-five patients to be instrumented with AVBGM were recruited. A patient-specific FEM was preoperatively generated using a 3D reconstruction obtained from biplanar radiographs. The FEM was used to assess different instrumentation configurations. The strategy offering the optimal 2-year postoperative correction was selected for surgery. Simulated 3D correction indices, as well as stresses applied on vertebral epiphyseal growth plates, intervertebral discs, and instrumentation, were computed. RESULTS On average, six configurations per case were tested. Immediate, 1-year, and 2-year postoperative 3D correction indices were predicted within 4° of that of actual results in coronal plane, whereas it was less then 0.8?cm (±2%) for spinal height. Immediate postoperative correction was of 40%, whereas an additional correction of respectively 13% and 3% occurred at 1- and 2 year postoperative. The convex/concave side computed forces difference at the apical level following AVBGM installation was decreased by 39% on growth plates and 46% on intervertebral discs. CONCLUSION This study demonstrates the FEM clinical usefulness to rationalize surgical planning by providing clinically relevant correction predictions. The AVBGM biomechanical effect on growth modulation over time seemed to be maximized during the first year following the installation. LEVEL OF EVIDENCE 3.